PubMed · 2090601
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T S Raman, C M Verma. 1990. Obstructive hydrocephalus.. https://pubmed.ncbi.nlm.nih.gov/2090601/
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Cerebrospinal fluid (CSF) flow in the cerebral aqueduct and spinal canal was analysed using real-time magnetic resonance imaging measurement techniques. Respiration-induced rhythmic modulation of the cardiac-related oscillating CSF pulsation in the cerebral aqueduct and spinal canal was found. Deep inspiration was immediately followed by a marked increase in downward CSF flow in the cervical spinal canal, whereas a delay of about two heart beats was seen before downward flow from the third to the fourth ventricle increased. This pattern was also detected during yawning and was followed by a marked increase of blood flow in the internal jugular vein.
The urofacial syndrome is an autosomal recessive disorder of distorted facial expression and neurogenic bladder with resultant urogenital tract damage. We report on an 8-year-old boy of consanguineous Arab parents with inverted facial expression upon laughing and renal changes as a consequence of a neurogenic bladder in addition to hydrocephalus due to stenosis of the aqueduct of Sylvius. We suggest that the association is not fortuitous and probably widens the spectrum of urofacial syndrome or represents a distinct entity mimicking the urofacial syndrome.
Evaluation of in utero shunting for fetal ventriculomegaly requires an analysis of the ex utero treatment of a comparison population of infants with idiopathic aqueductal stenosis (IAS). In this study, 14 neonates with IAS were followed with detailed developmental assessment profiles for 18 months or longer. Using magnetic resonance imaging, the preoperative and postoperative frontal cortical mantle widths (FCMW) were determined for each patient. Four of 14 children demonstrated normal outcomes while 5 of 14 children showed abnormal outcomes. The remaining 5 children demonstrated minimally impaired outcomes. No child with a postoperative FCMW below 30 mm showed normal development on any scale, while all children with abnormal development demonstrated a postoperative FCMW of 21 mm or less. In conclusion, the prognosis for normal long-term neurodevelopment in infants with IAS, despite prompt ex utero treatment, is guarded; the majority of such children will show developmental delays of varying degrees. The FCMW serves as a reasonable prognostic indicator in this patient population.